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2020, vol. 1, br. 2, str. 143-148
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Laparoskopski pristup lečenju inflamatornog miofibroblastnog tumora slezine, prikaz slučaja i pregled literature
Laparoscopic approach to the treatment of inflammatory myofibroblastic tumor of the spleen, case report and literature review
aKlinički centar Srbije, Klinika za digestivnu hirurgiju – I hirurška, Beograd, Srbija bPoliklinika "Health Care", Beograd cOpšta bolnica "Stefan Visoki", Smederevska Palanka
e-adresa: n.grubor@yahoo.com
Sažetak
Uvod: Benigni tumori slezine su retko oboljenje. Njihova patogeneza i klinička prezentacija predstavljaju dijagnostički i hirurški izazov, u smislu postavljanja prave dijagnoze i odabira adekvatnog hirurškog pristupa. Prikaz slučaja: U našem radu predstavljamo pacijentkinju staru 45 godina koja je započela ispitivanje zbog nespecifičnih tegoba u vidu povremenih bolova u levom gornjem kvadrantu abdomena. Vrednosti laboratorijskih parametara su bile u granicama normale, a preoperativna radiološka dijagnostika ukazivala je na postojanje promene u slezini koja je odgovarala tumoru. Shodno nalazu preoperativne dijagnostike, odlučili smo se za laparoskopsku splenektomiju. Postoperativni tok je protekao bez neželjenih događaja, a na otpustu pacijentkinji je propisana neophodna vakcinacija i antibiotska profilaksa. Zaključak: Miofibroblastni tumor slezine predstavlja nepoznanicu u smislu nastanka, sa veoma oskudnom i nespecifičnom prezentacijom simptoma, te se uvek mora ozbiljno pristupiti svakom pojedinačnom slučaju. Laparoskopija zauzima značajno mesto u lečenju ovog oboljenja, s obzirom na sve prednosti minimalno invazivnog pristupa u odnosu na otvorenu hirurgiju.
Abstract
Introduction: Benign tumors of the spleen are a rare condition. Their pathogenesis and clinical presentation represent a diagnostic and surgical challenge in the sense of establishing the correct diagnosis and selecting the appropriate surgical approach. Case report: In our paper, we are presenting a 45-year-old female patient who was initially tested and examined because of nonspecific complaints manifesting as occasional pain in the left upper quadrant of the abdomen. The values of the laboratory findings were within the reference range and preoperative radiological diagnostics indicated the existence of a mass in the spleen which had the features of a tumor. Based on the preoperative diagnostic finding we decided to perform laparoscopic splenectomy. Postoperative recovery was without adverse events, and the patient has prescribed the necessary vaccination and antibiotic prophylaxis. Conclusion: Myofibroblastic tumor of the spleen represents, as far as its origin is concerned, a mystery, with its very limited and nonspecific presentation of symptoms, which is why each individual case must be approached seriously. Laparoscopy has a very important role in the treatment of this disease, bearing in mind all the advantages of a minimally invasive approach over open surgery.
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